Cognitive impairment in patients with chronic pain: The significance of stress

  title={Cognitive impairment in patients with chronic pain: The significance of stress},
  author={Robert P. Hart and James B. Wade and Michael F. Martelli},
  journal={Current Pain and Headache Reports},
This review article examines the role of emotional distress and other aspects of suffering in the cognitive impairment that often is apparent in patients with chronic pain. Research suggests that pain-related negative emotions and stress potentially impact cognitive functioning independent of the effects of pain intensity. The anterior cingulate cortex is likely an integral component of the neural system that mediates the impact of pain-related distress on cognitive functions, such as the… 

Cognitive dysfunction and pain: considerations for future research.

The findings suggest that painful interruptions should not result in significantly greater performance decrement compared to other task interruptions once the activity is resumed, and raises the possibility that clinical pain does not interfere with activity resumption more than other every-day disruptions.

Comorbidity of Depression and Pain: a review of shared contributing mechanisms

In this review, the potential mechanisms that contribute to both depression and pain are discussed from four perspectives, the morphological changes in the brain, monoamine deficiency, brain-derived neurotrophic factor reduction in the hippocampus, and the hypothalamic-pituitary-adrenocortical (HPA) axis dysfunction.

The Problem of Pain

Fundamental issues that should be considered in understanding the nature of chronic pain including the distinction between acute and chronic pain; neurobiological distinctions between the lateral and medial pain system; nociceptive versus neuropathic or other central pain; sensitization effects; plus issues of response bias and malingering.

Involvement of the hippocampus in chronic pain and depression

The hypothesis that pro-inflammatory factors and neurotrophic factors expressed in the hippocampus may serve as a therapeutic target for comorbid chronic pain and depression is discussed.

Psychological Factors Influencing Chronic Pain and the Impact of Litigation

  • M. Jacobs
  • Medicine, Psychology
    Current Physical Medicine and Rehabilitation Reports
  • 2013
The biopsychosocial model with inclusion of clinical psychologists as members of the treatment team is essential and the important factors essential for a best practice approach to management of the spine pain patient with coexisting litigation are considered.

Pain Influences Neuropsychological Performance Following Electrical Injury: A Cross-Sectional Study.

Findings indicate that pain impacts mood and cognition in patients with EI, and the influence of pain and its effect on cognition should be considered in the assessment and treatment of patients who have experienced an electrical injury.

Chronic pain, stress, and the dynamics of affective differentiation.

This Dynamic Model of Affect (DMA) proposes that under conditions that promote maximal information processing, positive and negative affective systems function relatively independently, while under conditions characterized by uncertainty, including pain and stress, the affects become strongly inversely related.

Pain and mild traumatic brain injury: The implications of pain severity on emotional and cognitive functioning

High chronic pain exacerbates the emotional aspect of PCD and, therefore, should be given special observance in treatment settings.



Chronic Pain and Neuropsychological Functioning

Despite suggestive findings, further studies are needed to clarify the variables that mediate the impact of pain on neuropsychological functioning and the unique role of various symptoms often associated with chronic pain.

Cognitive Failure and Chronic Pain

  • Brian D. Dufton
  • Psychology
    International journal of psychiatry in medicine
  • 1989
The tendency to make cognitive errors was found to be related to emotional difficulties but to be unrelated to pain variables, suggesting that high rates of cognitive failure may predispose pain patients to have subsequent difficulties with low mood.

Neurocognitive Performance and Emotional Status in Chronic Pain Patients

It is suggested that level of emotional distress is associated with difficulties in a range of neurocognitive domains and have implications for the assessment and management of chronic pain patients.

Cognitive Impairment in Musculoskeletal Pain Patients

The need for further research to understand the relationship of poor performance on cognitive tasks to the etiology, maintenance and rehabilitation of pain problems is suggested.

The Influence of Problems with Concentration and Memory on Emotional Distress and Daily Activities in Chronic Pain Patients

The results showed that problems in concentration and memory were related to emotional distress, poor family support, and interference with daily activities.

The effects of depression and chronic pain on psychosocial and physical functioning.

Results of path analyses indicated that both somatic and cognitive symptoms of depression significantly correlate with psychosocial functioning even after controlling for the effects of pain level, trait anxiety, and trait anger.

Attention and somatic awareness in chronic pain